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Pharmacoeconomic Analysis of Brigatinib versus Alectinib in First‑Line Treatment of Anaplastic Lymphoma
Qingqing Chai1, Congling Gu2, Luis Hernandez3
1Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, China.
Introduction:
Brigatinib and alectinib are anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (ALK-TKIs) approved in China in 2022 and 2018, respectively, for the treatment of patients with ALK-positive, advanced non‑small‑cell lung cancer (NSCLC). The objective of this study is to conduct a comparative pharmacoeconomic analysis of first-line drugs, brigatinib and alectinib, in patients with ALK-positive NSCLC from the perspective of the Chinese healthcare system.
Methods:
A partitioned survival model with three health states was used to simulate the health outcomes and costs of brigatinib and alectinib with a 30-year time horizon. Indirect treatment comparisons (ITC) data were used to obtain the comparative efficacy of brigatinib and alectinib, owing to lack of head-to-head trials. As the health benefits were comparable between brigatinib and alectinib on the basis of the ITCs, cost-minimization analysis (CMA) was conducted. Cost-effectiveness analyses (CEA) were also conducted as scenario analyses using the different point estimates from the ITCs. Health state utilities and costs were obtained from public sources or clinical expert opinion. Direct medical costs and quality-adjusted life years (QALYs) were discounted at an annual rate of 5%. One-way sensitivity analyses were conducted for the CMA.
Results:
The CMA showed that, over 30 years, brigatinib (63,539 USD) was associated with cost savings of 14,203 USD compared with alectinib (77,742 USD). One-way sensitivity analyses showed that drug costs were the most influential parameter but brigatinib remained cost-saving in all the analyses. In the CEAs, the total cost of brigatinib was lower in all scenarios and also resulted in higher QALYs in 60% of the CEA scenarios.
Conclusions:
Brigatinib was a cost-saving (14,203 USD) treatment compared with alectinib in the CMA analysis for the first-line treatment of patients with ALK-positive advanced NSCLC in China.
Insights
Brigatinib offers significant cost savings compared to alectinib for first-line treatment of anaplastic lymphoma kinase-positive non-small cell lung cancer in China. This analysis demonstrates brigatinib as a cost-saving option for the Chinese healthcare system.
Area of Science:
- Pharmacoeconomics
- Oncology
- Health Economics
Background:
- Brigatinib and alectinib are anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) approved for ALK-positive advanced non-small cell lung cancer (NSCLC) in China.
- These ALK-TKIs were approved in China in 2022 (brigatinib) and 2018 (alectinib).
Purpose of the Study:
- To conduct a comparative pharmacoeconomic analysis of first-line brigatinib versus alectinib for ALK-positive advanced NSCLC.
- To evaluate the cost-effectiveness from the perspective of the Chinese healthcare system.
Main Methods:
- A partitioned survival model simulated health outcomes and costs over a 30-year horizon.
- Indirect treatment comparisons (ITC) were used due to the absence of head-to-head trials.
- Cost-minimization analysis (CMA) was performed, with cost-effectiveness analyses (CEA) as sensitivity analyses.
Main Results:
- Brigatinib demonstrated cost savings of $14,203 USD over 30 years compared to alectinib ($63,539 USD vs. $77,742 USD).
- Sensitivity analyses confirmed brigatinib as cost-saving, with drug costs being the most influential parameter.
- In CEA scenarios, brigatinib had lower total costs and higher quality-adjusted life years (QALYs) in 60% of cases.
Conclusions:
- Brigatinib is a cost-saving treatment option compared to alectinib for first-line treatment of ALK-positive advanced NSCLC in China.
- The CMA indicated a saving of $14,203 USD with brigatinib.
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